Working to Full Scope of Practice in unison with PN

Ethics: Wound Care, Tracheostomy's, and

Drains

Presented By: Chandra Campbell, Lisa Gillespie, DanilZaytsev, Navjot Saini

OVERVIEW

1.What is PN ethics2.The Code of ethics 3.Spheres of the scope of practice4.Ethical Principles5.Ethical Principles and Nursing Practice6.Accepting Accountability7.Tracheostomy’s8.Wound Care9.When things go beyond scope10.Drains11.Consultation for Assistance

What is PN Ethics?

Protects Clients

Code of ethics

Guide what is right and wrong

Motives behind determining outcomes through those actions and their consequences of those actions on clients

Support guiding actions nursing related

The Code of Ethics

The "Code of Ethics and Standards of Practice" for licensed practical nurses of Alberta is a foundation of our profession (CLPNA: Code of Ethics and Standards of Practice, 2008, p.2). It serves us as a reference guide for building ethical relationships with our colleagues and patients, it explains our responsibilities on workplace, and directs our practice towards standards of law and existing regulations. This ethical foundation also underlines the role of philosophical values in our profession such as personal obligations, individual commitments, and believes by establishing ethical standards in order to match expectations of general public and community. The code also serves us as a tool for self reflective evaluation and it is essential for maintaining safe, companionate, and ethical environment in our workplace (CLPNA: Code of Ethics and Standards of Practice, 2008, p.2).

The Code of Ethics is based on several assumptions such as promotion of health and well-being to all patients, preserving their dignity, maintaining privacy and confidentiality, promotion of justice, and accountability that should never be compromised by any means

(Cassells & Gaul, 1998, p.10)

Spheres of the Scope of Practice

CLPNA

Institutional Policies

Student’s Scope

Ethical Principles

Through guiding principles as professionals we are able to :

make informed decisions

Deliver more competent care

Are in place to PROTECT THE RIGHTS of the individuals we care for

These principles are the rights for clients:

1.Autonomy

2.Nonmaleficence

3.Justice

4.Fidelity

5.Veracity

6.Accountability

What these Principles mean in current nursing practice

Autonomy-Right to make decisions that impact oneself and take action from those decisions,

Nonmalificence-Do no harm

Beneficence-act in the best interest of others, includes client advocacy, 3 parts: Promote good, prevent harm or evil, Remove Harm or evil

Fedelity-Faithful to ethical principles, and code of ethics for nursing, keeping commitments and promises made to clients

Justice-Fair, equitable, and appropriate treatment, equal distribution of resources

Veracity-To tell the truth

Accountability-Being answerable to self and others based on action, includes responsibility for ones actions for procedures performed as a nurse

Accepting Accountability

Ethical Principles

Scope of practice

Common Drains

Tracheostomy tubes

Tracheostomy tubes

Cuffed tube with disposable and reusable inner cannula

Tracheostomy Tubes

Cuff less Tube with disposable and reusable inner cannula

Types of Tracheostomy tubes

Fenestrated cuffed and cufflesstracheostomy tubes

Wound Care

beyond the dermis beyond

beyond the point in the nasal passages where they normally narrow

the external ear canal

beyond the pharynx

beyond the opening of the urethra

beyond the labia majora

beyond the anal verge

into an artificial opening into the body.

http://peltons.com/

When to stop: Anatomical levels of reference

http://www.health.gov.bc.ca/professional-regulation/hpc/review/part-i/scope-lpnurse.html#IIIA1

When Things Go Beyond Scope of practice

When it is considered that the needs of the patientgo beyond the scope of practice of LPN, the RN wouldtake accountability for the client’s care, in opendiscussion with RN practical nurse should decide which ofthe following options would be the most appropriate:

• RN and LPN work together to provide the required care

• LPN works under the supervision or guidance of RN

(direct/indirect)

• LPN delegate the care for the client to RN

https://www.youtube.com/watch?v=uXBssToP4gk

Drains: Working within the LPN Scope .

Within Scope of

Practise

Outside Scope of Practise

• Jackson Pratt Drain• Nasogastric Tubes (NG Tubes)• Hemovac Drain • Blake Drain • Davol Drain • Flex-I Seal Rectal Tube& Collecting System• Penrose Drain

• Percutaneous Drain/ Stent:

Cook drain/ Pigtail drain/ CT drain• Malecot Drain• T-Tube Drain

Purpose: Seek clarification, assistance and exterior knowledgeto assist in decision making pertaining to critical thinking and administration of care.

Resource's available:

• Fellow Staff Members• Alberta Health Services Policy • & Procedures Manual• Unit In-Service/ Education Days• Charge Nurse• Specialized Nursing Staff (Wound Care)• **Unit Educator**

Priority: Patient Safety!

From Us to You

Nursing comes with a price we all must pay and the path is not always laid with gold. Work hard to learn what you can as students’ knowledge is something we strive for to make us not just better nurses but people as well.

It is the people we care for that teach us about life, values, and form the experiences that help us grow as individuals in our practice.

It’s our responsibility to ensure their safety in our care as we grow, learn, laugh, and cry with them through their experiences to apply it so that the gold we weave can make a lasting impact on the lives we will touch throughout our careers.

Reference Bow Valley College, BVC. (2014). Practical nursing program diploma curriculum. Calgary, AB: BVCCanadian Council for Practical Nurse Regulation, CCPNR. (2013). Code of ethics for licensed practical nurses in Canada. Retrieved from: http://www.clpna.com/wp-content/uploads/2013/02/doc_CCPNR_CLPNA_Code_of_Ethics.pdf

College of Licenced Practical Nurses of Alberta. (2013). Pp. 04, 05. Retrieved fromhttp://www.clpna.com/wpcontent/uploads/2013/02/doc_CCPNR_CLPNA_Standards_of_ Practice.pds

College of Licensed Practical Nurses of Alberta, CLPNA. (2008). Code of ethics and standards of practice. Retrieved from: http://www.clpna.com/wp- content/uploads/2013 /02/doc_CLPNAEthics-Standards.pdf

Cassells, J., & Gaul, A. (1998). An ethical assessment framework for nursing practice. Maryland Nurse, 17(1), 9-12.

Hogan A. (2012). Comprehensive review for NCLEX-PN Reviews & Rationales (2nd ed.), Amherst: Pearson Education Inc.

Kozier, B., Erb, G., Berman, A., Snyder, S., Bouchal, D. S. R., Hirst, S., et al. (2010). Fundamentals of Canadian nursing: Concepts, process, and practice (2nd Canadian ed.). Toronto: Pearson Education

Linton A. (2012). Introduction to medical-surgical nursing. (5th ed.), Philadelphia: Saunders Elsevier